June 23--ROCKFORD -- Health care leaders in the Rockford area are taking a wait-and-see approach before they form an opinion on the merits of a Senate bill that would dismantle much of the Affordable Care Act. But one thing is clear: hundreds of thousands of Illinoisans could lose coverage in four years if the bill becomes law.

Senate leaders have worked on the bill in private for weeks and went public today with the language of their proposal. It's similar to the bill passed by the House in May, but with several key differences, including cuts and structural changes to Medicaid, which insures one in five Americans.

"No one's really had a chance yet to dissect the 142-page bill entirely, but it's clearly going to be most detrimental to Illinois, which currently ranks last among all 50 states for Medicaid funding," said Mark Gridley, president and CEO of FHN, Freeport's largest employer and the parent of FHN Memorial Hospital.

The Affordable Care Act has provided insurance for about 1 million people in Illinois -- 650,000 residents through the expansion of Medicaid and another 350,000 via marketplace insurance plans.

The Senate bill would reduce Medicaid expansion coverage for many low-income adults across the country, but it would happen sooner in Illinois, Gridley said.

The Senate bill would reduce federal payments to states for Medicaid expansion by 5 percentage points per year beginning in 2020. However, a 2013 state "trigger" law designed to keep Medicaid spending in check requires Illinois to stop providing Medicaid expansion benefits if federal funding dips below 90 percent. That would happen in 2021, if the Senate bill became law.

"The 650,000 people who were added to Medicaid in Illinois would lose their coverage within 90 days when that happens," Gridley said.

OSF HealthCare leaders remain concerned about any proposal that cuts access to care or curtails Medicaid spending. Administrators at the Peoria-based health system, the parent of Rockford'sOSF Saint Anthony Medical Center, declined the Register Star's request for an interview today and referred to a written statement that the health system issued in March when the House was working on its bill.

"The elimination of pre-existing conditions restrictions, the ability for those under 26 years of age to continue on their parents' insurance, and the expansion of Medicaid are certainly areas to be continued," the statement said. "Issues around the affordability of both Medicaid and benefit plans offered through the public exchanges must be addressed."